Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, Korea.
Abdom Radiol (NY). 2020 Dec;45(12):4235-4243. doi: 10.1007/s00261-020-02776-0. Epub 2020 Sep 23.
To compare the diagnostic performance between diffusion kurtosis imaging (DKI) parameters and mono-exponential apparent diffusion coefficient (ADC) for determination of clinically significant cancer (CSC, Gleason score (GS) ≥ 7) in patients with histologically proven prostate cancer (PCa).
A total of 92 patients (mean age: 71.5 years, range: 47-89 years) who had been diagnosed as PCa and undergone 3 T-MRI including DWI (b values, 0, 100, 1000, 2000s/mm) were included in this study. The DKI parameters, namely apparent diffusion for non-Gaussian distribution (D) and apparent kurtosis coefficient (K), were calculated by dedicated software using mono-exponential and diffusion kurtosis models for quantitation. The measurement was performed for a whole tumor after segmentation, and pathologic topographic maps or systemic biopsy results served as the reference standard for segmentation. To compare the diagnostic performance of each parameter for determination of CSC, pair-wise comparison of receiver operating characteristic (ROC) curves was performed.
The study population consisted of GS 6 (n = 18), GS 7 (n = 31), GS 8 (n = 25), GS 9 (n = 15) and GS 10 (n = 3) patients. The area under the ROC curve of K (0.707, 95% CI 0.603-0.798) for discriminating CSC from non-CSC was not significantly different from those of mono-exponential ADC (0.725, 0.622-0.813, P = 0.2175) or D (0.726, 0.623-0.814, P = 0.9628). Diagnostic predictive values of K were estimated to a maximum accuracy of 78%, a sensitivity of 86%, and a specificity of 47%, while those of mono-exponential ADC were 75, 81, and 53%, respectively.
The DKI parameters showed a diagnostic performance comparable to mono-exponential ADC for determination of CSC in patients with PCa.
比较扩散峰度成像（DKI）参数与单指数表观扩散系数（ADC）在诊断组织学证实的前列腺癌（PCa）患者中临床显著癌（CSC，Gleason 评分（GS）≥7）中的诊断效能。
本研究共纳入 92 例经 3T-MRI 检查（b 值为 0、100、1000、2000s/mm）并诊断为 PCa 的患者（平均年龄 71.5 岁，范围 47-89 岁）。通过专用软件使用单指数和扩散峰度模型计算 DKI 参数，即非高斯分布的表观扩散系数（D）和表观峰度系数（K）。对整个肿瘤进行分段测量，病理地形图或系统活检结果作为分段的参考标准。为了比较每个参数在诊断 CSC 中的诊断性能，我们对 ROC 曲线进行了两两比较。
该研究人群包括 GS 6（n=18）、GS 7（n=31）、GS 8（n=25）、GS 9（n=15）和 GS 10（n=3）患者。K（0.707，95%CI 0.603-0.798）的 ROC 曲线下面积（AUC）用于区分 CSC 和非 CSC 与单指数 ADC（0.725，0.622-0.813，P=0.2175）或 D（0.726，0.623-0.814，P=0.9628）的 AUC 无显著差异。K 的诊断预测值估计最大准确性为 78%，灵敏度为 86%，特异性为 47%，而单指数 ADC 的分别为 75%、81%和 53%。
DKI 参数在诊断 PCa 患者的 CSC 方面的诊断性能与单指数 ADC 相当。
